When it comes to psychological treatment, there is no one-size-fits-all approach. As individuals differ in various aspects of their lives and personalities, their challenges, needs, and goals vary equally. Consequently, different approaches have been developed over the decades. You may have heard of CBT, Schema Therapy, and other similar approaches, to name a few. To make the choice easier and help you gain a basic understanding of the various options, we have compiled this overview of the most common therapy modalities used today, though it is by no means exhaustive.

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) was originally developed by Aaron Beck in the 1960s and 1970s, and is generally a short-term, present-oriented form of therapy. It is goal-oriented, follows a highly structured course, and is among the most well-studied, evidence-based approaches. CBT relies on the notion that thoughts, feelings and behaviours are interconnected and influence our mood. Therefore, negative thoughts can cause distress.

Consequently, in therapy, the aim is to change unhealthy ways of thinking and adopt healthier, more realistic ones through various techniques and exercises. Essentially, the process consists of identifying dysfunctional ways of thinking, recognising and distinguishing between rational and irrational thoughts, and eventually managing them by developing strategies to challenge and reframe negative thought patterns. This way, CBT encourages individuals to become their own therapists and learn tools they can use anytime to prevent falling back into old patterns. CBT can be used for a range of problems, including depression and anxiety. Despite CBT’s high success rate, it can feel too shallow for some due to its present - and symptom-oriented focus

Schema Therapy

Schema Therapy, developed by Jeffrey Young in the 1990s, integrates elements of CBT, psychodynamic therapy, and other approaches. Originally, schema therapy was developed for the treatment of Borderline Personality Disorder due to CBT not having proven effective. However, over time, it has proven helpful for individuals struggling with longstanding emotional difficulties such as chronic depression, anxiety, or low self-esteem, and relational problems. It operates on the core principle that humans develop mental “blueprints” - called schemas - for how the world and relationships work. These deeply rooted emotional patterns start developing in childhood and continue to shape how they think, feel, and relate to others. When basic emotional needs are not met during childhood, this can result in the formation of maladaptive (unhealthy) schemas, which are thought to continue to influence an individual’s thoughts, behaviours and relationships in adulthood. Consequently, schema therapy aims to help individuals identify their schemas and understand their origins, and teaches them to address their emotional needs through various exercises. Unlike CBT, Schema Therapy examines not only symptoms but also the underlying patterns. It strikes a balance between structure and emotional depth, offering both practical tools and deeper self-understanding. A potential drawback of schema therapy is that it requires a longer time commitment.

Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT), developed by Marsha Linehan in the 1980s, builds on CBT and helps people manage intense emotions, self-destructive behaviours, eating disorders, and other challenges. Originally for borderline personality disorder, DBT balances acceptance and change, teaching skills like mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Like Schema Therapy, DBT often requires time and combines individual and group sessions. The structured process aims to build resilience and healthy coping strategies.

Eye Movement Desensitisation and Reprocessing (EMDR)

Eye Movement Desensitisation and Reprocessing (EMDR) is a type of psychological therapy developed in 1987 by clinical psychologist Francine Shapiro. Initially, the method was applied to treat traumatic memories which may have developed as a result of various traumatic experiences (e.g., assault, an accident, natural disaster, neglect or bullying, etc.). Although its most familiar use is the treatment of Post Traumatic Stress Disorder (PTSD), EMDR is nowadays also used to treat other conditions, including phobias, other forms of anxiety, grief, psychosomatic disorders, or sexual dysfunction disorders. EMDR therapy aims to influence neural pathways in the brain and helps re-evaluate thoughts and emotions associated with unpleasant memories. As a result, the emotional distress associated with these memories diminishes over time. This is done by activating both the left and right hemispheres of the brain (bilateral stimulation) through visual stimulation (e.g., following an object with the gaze), tapping, buzzers, or sounds. Whilst doing so, the client recalls the difficult event from their past, remaining conscious throughout the entire process. A great deal of importance is placed on giving the client a sense of maintaining control over what is happening. While generally considered a highly effective treatment, EMDR is unsuitable for individuals struggling with severe addiction, epilepsy, eye conditions, or organic brain disorders.

Client-Centred (Person-Centred) Therapy

Developed by Carl Rogers in the early 1940s, and also referred to as Rogerian therapy, this approach is non-directive and relies on the principle that the client is the expert of their life and takes the lead in shaping the direction of therapy. In contrast, the therapist takes a non-directive approach. Instead, the therapist’s main role is to provide a safe, non-judgmental, supportive space in which the client can explore their inner world without censorship. During this exploration, the therapist aims to increase the client’s self-understanding and awareness by asking clarifying questions that prompt reflection. The therapist offers unconditional positive regard and empathic understanding throughout. The goals and benefits of this approach are increased self-esteem and self-acceptance, as well as self-understanding and awareness. Moreover, the ability to express feelings is enhanced, making personal growth and positive psychological functioning core points of focus. Applying this approach to many different topics can feel vague and unstructured to some individuals. Lastly, while few therapists today rely solely on client-centred therapy, it is often integrated into practice alongside other approaches.

Emotion-Focused Therapy (EFT)

Originally formulated by Sue Johnson and Les Greenberg in the 1980s, EFT aims to help individuals, couples, and families use emotions as a guide to understand their needs and, consequently, resolve issues and improve relationships. Especially when applied to couples, it draws on attachment theory to explore how past experiences shape current relationship patterns. During sessions, clients learn to fully experience and express their emotions. This is to help them transform unhealthy emotional responses into healthy ones. Meanwhile, the therapist provides a safe, empathic space and supports clients in exploring their emotions. Given the nature of this approach, sessions can feel intense and unstructured to some individuals. Overall, it is most commonly applied as couples therapy as well as treating anxiety, trauma and depression.

Psychodynamic Therapy

Psychodynamic therapy builds on psychoanalytic therapy, both of which are based on the work of Sigmund Freud. It is often used to treat various disorders and to understand relationship difficulties, recurring themes, and life patterns. A core principle of psychodynamic therapy is to explore and gain awareness of how the unconscious and past experiences drive current behaviours and patterns. Through various techniques such as free association, transference, and countertransference, unresolved and repressed issues are processed, leading to insight and positive change. While this approach can be beneficial for individuals with the capacity for self-reflection and a desire for insight, it can feel unstructured to others. Although related, psychodynamic therapy is shorter than psychoanalysis and often focuses on specific problems.

Acceptance and Commitment Therapy (ACT)

Developed in the 1980s by Steven C. Hayes, ACT is action-oriented and rooted in CBT and traditional behaviour therapy. It incorporates mindfulness and helps people accept difficult inner emotions as appropriate to certain situations, rather than denying or avoiding them. This promotes psychological flexibility through six core processes:

• Acceptance - Acknowledging and embracing thoughts and emotions

• Cognitive Defusion - Distancing oneself and observing difficult thoughts and feelings without judgment, rather than trying to change them.

• Being present - Staying mindful in the present and observing thoughts without change

• Self as Context - Understanding that one is more than one’s thoughts and feelings

• Values - Choosing personal values in various domains and striving to live accordingly

• Committed Action - Taking concrete steps to align changes with personal values for positive change

ACT rests on the notion that to control painful emotions is counterproductive, as suppression leads to more distress. It is used to treat various conditions. The benefit of ACT is its modern and practical nature; however, it is also less focused on symptom reduction.

Integrative / Eclectic Therapy

Integrative or eclectic therapy is a flexible approach customised to each client's unique needs. The therapist blends a variety of disciplines and may use multiple techniques from different theories. Common techniques and approaches include CBT, psychodynamic approaches, humanistic therapies, and Gestalt therapy. It is often used to treat complex issues with multifaceted problems like anxiety, depression or relational problems. While it may feel unstructured, it can be highly beneficial for clients who prefer flexibility or do not fit into specific categories.

Choosing the right Modality

When deciding on an approach, it is perfectly acceptable to take some time for the process. It can be overwhelming given the myriad of modalities available, not all of which have been outlined in this article. What might make it easier is to consider your specific goals, the severity of your concerns, your personality, and, of course, the therapist’s training. You are always allowed to ask therapists about their approach. More importantly, there is no one 'best' therapy; there is only one that is collaborative and fits you personally.

If you do have further questions, you are more than welcome to reach out to us via the contact form. We would be happy to help you and answer any questions you might have.